In pediatric shock, which of the following is a cause of obstructive shock?

Correct Answer: C

Rationale: In pediatric shock, obstructive shock occurs due to mechanical obstruction to blood flow. The correct answer is C) Severe aortic stenosis because it leads to obstruction of blood flow from the left ventricle, causing decreased cardiac output and subsequent shock. Option A) Myocardial infarction is incorrect because it typically leads to distributive shock due to systemic vasodilation. Option B) Myocarditis is incorrect as it causes cardiogenic shock due to myocardial dysfunction rather than mechanical obstruction. Option D) Severe mitral regurgitation is incorrect as it causes cardiogenic shock by decreasing forward blood flow, not by obstructing blood flow. Understanding the etiology of different types of shock in pediatric patients is crucial for nurses to provide timely and appropriate interventions. Recognizing the specific causes of obstructive shock can help nurses implement targeted treatments such as inotropic support or surgical interventions to alleviate the obstruction and improve cardiac output. This knowledge is essential for pediatric nurses to effectively manage critically ill children and optimize patient outcomes.

Correct Answer: C

Rationale: Metabolic acidosis with a large anion gap is often caused by the accumulation of acids like lactic acid, ketoacids, or toxins such as salicylates. In this scenario, option C, Salicylate overdose, is the likely cause. Salicylate overdose can lead to an increase in the anion gap due to the accumulation of salicylic acid and its metabolites. Option A, Diarrhea, typically causes non-anion gap metabolic acidosis due to the loss of bicarbonate in the stool. Option B, Renal failure on regular dialysis, is less likely to cause metabolic acidosis with a large anion gap as dialysis helps in removing excess acids and correcting acid-base imbalances. Option D, Severe chronic iron deficiency anemia, does not directly contribute to metabolic acidosis with a large anion gap. In an educational context, understanding the causes of metabolic acidosis and how to interpret anion gap values is crucial for pediatric nurses to provide safe and effective care to children with complex medical conditions. Recognizing the etiology of acid-base imbalances helps nurses intervene promptly and collaborate with the healthcare team to ensure optimal patient outcomes.

Correct Answer: C

Rationale: The Look-Listen-Feel procedure is used to assess for breathing in pediatric patients during a primary assessment. This technique involves looking for chest rise and fall, listening for breath sounds, and feeling for airflow. Option A, assessing for responsiveness, is not correct in this context as the Look-Listen-Feel procedure specifically focuses on assessing breathing, not responsiveness. Option B, assessing for airway patency, is important in pediatric assessments, but it is not the primary focus of the Look-Listen-Feel technique. Airway patency is typically assessed before or after using the Look-Listen-Feel method. Option D, assessing for circulation, is also crucial in pediatric assessments, but it is not the purpose of the Look-Listen-Feel procedure. Circulation is assessed through checking for a pulse and signs of perfusion. Educationally, understanding the correct use of the Look-Listen-Feel technique is essential for pediatric nurses as it helps them quickly and effectively assess a child's breathing status in emergency situations. Mastery of this skill can make a significant difference in providing timely and appropriate interventions for pediatric patients in respiratory distress.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding the use of inotropic drugs in acute shock is crucial for providing safe and effective care to pediatric patients. In the given question, the correct answer is D) Milrinone. Milrinone is a phosphodiesterase inhibitor that enhances cardiac contractility and is commonly used in the management of acute heart failure, not typically in acute shock situations. A) Digitalis is a cardiac glycoside that increases myocardial contractility but is not typically used in acute shock due to its slower onset of action and potential for toxicity in critically ill patients. B) Dopamine is a catecholamine that acts on adrenergic receptors to increase cardiac output and blood pressure, making it a common choice in treating acute shock. C) Dobutamine is a beta-1 adrenergic agonist that also increases cardiac contractility and is often used in acute shock to improve cardiac output. Educationally, understanding the differences between these inotropic drugs is essential for pediatric nurses to make informed decisions in managing pediatric patients in critical condition. By grasping the pharmacological properties and appropriate clinical indications of these medications, nurses can optimize patient outcomes and provide quality care in acute care settings.

Correct Answer: B

Rationale: The correct answer is B) 12 mmol/L. In the treatment of hypernatremia, it is crucial to correct the serum sodium levels gradually to prevent the risk of cerebral edema and other serious complications. Rapid correction can lead to osmotic demyelination syndrome, a severe and potentially fatal condition. Option A) 8 mmol/L is too conservative and might not effectively correct hypernatremia within a reasonable timeframe, especially in cases of severe hypernatremia where a more rapid correction is required to prevent brain injury. Option C) 16 mmol/L and Option D) 20 mmol/L are too aggressive and pose a significant risk of causing rapid changes in serum sodium levels, leading to adverse neurological effects. In a clinical setting, nurses caring for pediatric patients with hypernatremia must closely monitor and adjust the rate of correction as per guidelines to ensure patient safety. Understanding the appropriate rate of correction is essential for pediatric nurses to provide safe and effective care to children with electrolyte imbalances.